Dose-Adjusted R-EPOCH Therapy for Aggressive Lymphoma: A single center experience

Objective: When we look at diffuse large B-cell lymphomas, 5-7% are double hit lymphoma, 30-40% are double expressor lymphoma and 5-10% are triple hit lymphomas and they have an aggressive course. In our study, the efficacy of the dose-adjusted-R-EPOCH treatment regimen in the treatment of double hit lymphoma, double expressor lymphoma, triple hit lymphoma; triple expressor lymphoma and primary large B cell lymphomas of the mediastinum are presented. Materials and Methods: Thirty-six patients diagnosed with B-cell lymphoma who received dose-adjusted R-EPOCH treatment were included in the study. The patients were grouped cytogenetically according to the Bcl-2 and Bcl-6 rearrangement by MYC translocation. Response assessment with PET-CT was performed in patients whose planned therapy reached the number of cycles. Results: At the end of the treatment, 61% of the patients had a complete response, 3% had a partial response, and 8% had no response. During the follow-up, 9 of the patients died and while the treatment of 2 patients was still ongoing, the treatment regimen of 1 patient was changed. When the patients were evaluated, 2 had double hit lymphoma (complete response in 2 patients), 9 had double expressive lymphoma (5 patients had complete response, 2 patients had progressed disease, 1 patient died and 1 patient had a change in treatment), and 8 had triple expressor lymphoma (Complete response in 5 patients, death in 2 patients, and progressive disease in 1 patient). Conclusion: The dose-adjusted-R-EPOCH treatment regimen can also provide a high response rate in patients with lymphoma with a triple expressor cytogenetic subtype.